Written Answers Nos. 164-183
164. Deputy Declan Breathnach asked the Minister for Health if arrangements will be made to reopen the Civil Registration Office in Dundalk, County Louth; his views on whether it is unacceptable for persons in the north of the county to have to travel over 60 km to access this service now located in Drogheda; and if he will make a statement on the matter. [16936/18]
Amharc ar fhreagraThe Civil Registration Service is operated by the Health Service Executive on behalf of the General Register Office under the aegis of the Department of Employment Affairs and Social Protection. I have referred your question to the Health Service Executive for direct reply to you.
165. Deputy Thomas P. Broughan asked the Minister for Health the amount spent per day by the HSE on taxis; the amount spent on accessible taxis; and if he will make a statement on the matter. [16947/18]
Amharc ar fhreagraThis matter has been referred to the HSE for direct reply.
166. Deputy Thomas P. Broughan asked the Minister for Health if his Department has undertaken a cost benefit analysis and plans to increase personal assistant hours for persons with disabilities; and if he will make a statement on the matter. [16948/18]
Amharc ar fhreagra167. Deputy Thomas P. Broughan asked the Minister for Health the cost of increasing personal assistance hours by 500,000 hours; his plans to improve the personal assistance service for persons with disabilities; and if he will make a statement on the matter. [16949/18]
Amharc ar fhreagraI propose to take Questions Nos. 166 and 167 together.
In the 2018 National Service Plan, the HSE's priority is to provide 1.46 million hours of personal assistance to more than 2,000 people with disability, representing an increase of 60,000 hours over the 2017 target of 1.4 million hours.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
168. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [16957/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
169. Deputy Declan Breathnach asked the Minister for Health if the FreeStyle Libre reimbursement scheme will be extended to all persons with type 1 diabetes; if not, the reason for excluding older persons from the scheme; and if he will make a statement on the matter. [16958/18]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
170. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [16965/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
171. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [16968/18]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
172. Deputy Bobby Aylward asked the Minister for Health if he will publish the review of the pricing system for long-term residential care facilities as recommended within the review of the fair deal scheme; if an independent appeals mechanism will be introduced within the fair deal scheme to provide third party recourse for nursing home providers that fail to agree a fee with the NTPF and in an effort to bring greater transparency to the fair deal pricing mechanism; and if he will make a statement on the matter. [16969/18]
Amharc ar fhreagraThe Report of the Nursing Homes Support Scheme (NHSS) Review published in 2015 identified a number of issues for more detailed consideration, including a review of pricing mechanism by the National Treatment Purchase Fund (NTPF), with a view to:
- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee this review which is chaired by the NTPF and includes representatives from my Department and the Department of Public Expenditure and Reform. The NTPF have responsibility for the development of this report, although Department Officials continue to engage with the NTPF regarding the review. The most recent update from the NTPF is that the report will be finalised and ready for review in the first half of 2018.
With regard to the Deputy’s question on plans to introduce an independent appeal mechanism within the NHSS to provide third party recourse for nursing home providers that cannot agree a fee with the NTPF, I cannot nor would I wish to, prejudge the outcomes of the NTPF pricing mechanism review. However I welcome the work to date and look forward to the NTPF concluding the review later this year.
173. Deputy Maureen O'Sullivan asked the Minister for Health the HSE's policy in relation to Suboxone take-away doses; and if he will make a statement on the matter. [16989/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
175. Deputy Maureen O'Sullivan asked the Minister for Health if evidence which shows that millions of smokers have successfully quit smoking by switching to e-cigarettes has been examined; the action his Department is taking to support the transition to e-cigarettes as a means of quitting smoking; and if he will make a statement on the matter. [16991/18]
Amharc ar fhreagraSmoking is the greatest single cause of preventable illness and premature death in Ireland, killing almost 6,000 people a year.
The primary objectives set out in the Tobacco Free Ireland (2013) policy document are to denormalise smoking and to protect children from the dangers of tobacco consumption. Tobacco Free Ireland sets a target for Ireland to be tobacco free (i.e. with a prevalence rate of less than 5%) by 2025.
Tobacco Free Ireland contains a number of recommendations to assist smokers in quitting tobacco use. One of those recommendations is to examine the evidence regarding the outcomes of the use of Nicotine Replacement Therapy ('NRT') and other approaches.
My Department requested HIQA to undertake a Health Technology Assessment ('HTA') of the clinical and cost effectiveness of pharmaceutical and non-pharmaceutical smoking cessation products and services. The HTA was published in 2017 and found that all the pharmacological interventions were effective compared to no treatment and that a prescription only drug called varenicline was the most effective drug on its own. However, the HTA also found that using a combination of varenicline and NRT was the most effective pharmacological intervention and that people using this combination were over three and a half times more likely to quit than those who were in a control group and did not receive this treatment.
Group behavioural therapy, individual counselling, intensive advice and telephone support were all found to be effective behavioural interventions with group therapy found to be the most effective of these interventions. The addition of a behavioural intervention to a pharmacological intervention improved the effectiveness of the intervention.
The HTA recommended that smoking cessation services should seek to increase the uptake of varenicline, either alone or in combination with NRT, for smokers who want to use a pharmacological support.
In relation to e-cigarettes and vaping, although the HTA found that results for e-cigarettes are promising, there is currently a lack of evidence to recommend their use as a smoking cessation aid and at present no e-cigarette product is licensed as a medicinal product in Ireland. The safety of e-cigarettes is an evolving area of research; while potentially safer than smoking, evidence on its long-term safety has yet to be established. In the absence of additional evidence confirming the effectiveness of e-cigarettes, the HTA recommended that the HSE smoking cessation services should seek to increase the uptake of combination NRT treatment among those for whom varenicline is contraindicated, not tolerated or not preferred.
The results of the HTA are informing the development by the HSE, in conjunction with the National Clinical Effectiveness Committee, of national clinical guidelines.
Current evidence-based means of quitting include behavioural support and pharmacotherapies. The HSE provides and promotes these safe and evidence-based services, supports and aids to help people to quit. The HSE recommends that those wishing to give up smoking uses its cessation services as the first port of call.
My Department will continue to monitor the emerging research on all products, so as to inform decisions around any future additional regulation in this area.
176. Deputy Maureen O'Sullivan asked the Minister for Health if the commitment in the programme for Government to introduce cystic fibrosis beds for Beaumont Hospital will be implemented; and if he will make a statement on the matter. [16993/18]
Amharc ar fhreagraThe Programme for Partnership Government contains a Government commitment regarding the development of a dedicated Cystic Fibrosis (CF) Unit in Beaumont Hospital, to be progressed in the context of a CF Model of Care.
This CF Unit capital project will thus be underpinned by the “Model of Care for People with Cystic Fibrosis in Ireland” which is being developed by the National Clinical Programme for Cystic Fibrosis (NCPCF). The Model of Care will set out standards and requirements for the physical and human resources to be provided for treatment of cystic fibrosis patients from a national perspective.
The Department of Public Expenditure and Reform governs the processes surrounding the development of healthcare projects by way of guidelines, principally the Public Spending Code. Further rigour is demanded by, and set out in, relevant EU Directives. All proposed projects must be submitted to the HSE’s Capital and Property Steering Committee for approval and prioritisation prior to inclusion in its multi-annual Capital Plans.
In terms of the progression of the CF Unit capital project I am happy to confirm that it has been included in the National Planning Framework under Project Ireland 2040, as well as being recommended for inclusion in the capital plan by the HSE National Capital Steering Committee.
177. Deputy Maureen O'Sullivan asked the Minister for Health the status of plans to bring forward a soft opt-out organ donation system; and when legislation will be introduced in this regard [16994/18]
Amharc ar fhreagraThe Government approved the preparation of a General Scheme and Heads of a Human Tissue Bill last year. The proposed legislation will include provisions for a soft opt-out organ donation system.
Work on drafting the General Scheme is progressing and it is proposed to seek Government approval to publish the General Scheme shortly.
178. Deputy Niamh Smyth asked the Minister for Health the reason persons diagnosed with cancer are not automatically being granted a medical card to alleviate the financial burden and stress during their treatment; and if he will make a statement on the matter. [16995/18]
Amharc ar fhreagraThe HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
Medical card provision is based on financial assessment. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.
179. Deputy Robert Troy asked the Minister for Health if allocated hours of home help service will be commenced for a person (details supplied); and if he will make a statement on the matter. [17001/18]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
180. Deputy Robert Troy asked the Minister for Health if a decision not to grant home help to a person (details supplied) will be reviewed with a view to making hours available in this case; and if he will make a statement on the matter. [17002/18]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
181. Deputy Tony McLoughlin asked the Minister for Health the status of the provision of the new primary care centre in Carrick-on-Shannon, County Leitrim; and if he will make a statement on the matter. [17021/18]
Amharc ar fhreagraAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
182. Deputy Martin Heydon asked the Minister for Health if the salary scale for the CEO position of a section 38 agency (details supplied) in County Kildare will be reviewed; and if he will make a statement on the matter. [17022/18]
Amharc ar fhreagraIn 2015, my Department completed a review of the appropriate salary levels for the CEOs of Section 38 funded agencies, in conjunction with the HSE and the Department of Public Expenditure and Reform (DPER). The review was carried out on foot of Recommendation No. 20 in the HSE’s Internal Audit report on the remuneration of senior managers in Section 38 agencies. This recommendation stated that a review of the remuneration rates of CEOs and senior management was required for a number of organisations, particularly in the social care area, to ensure pay rates reflect the comparable size, scale and complexity of each organisation.
Completion of this banding exercise was an important stage in addressing non-compliance with Government pay policy as it provided clarity on the appropriate rate of pay for all the CEO posts in Section 38 funded agencies.
Currently, the approved rate of pay for a newly appointed CEO post in the agency referred to by the Deputy is €66,470 - €79,679.
In instances where a Section 38 organisation can demonstrate that it has attempted to fill a post but has been unsuccessful in attracting suitable applicants, there may be grounds for a business case to be made to the HSE to seek an increase in the remuneration level payable. If the HSE were supportive, it would then be considered by my Department. Given the senior level of the post in question, sanction would also be required from the Department of Public Expenditure and Reform.
183. Deputy Martin Heydon asked the Minister for Health the status of work to address concerns on the future availability of general practitioners nationally; and if he will make a statement on the matter. [17023/18]
Amharc ar fhreagraThe Government is committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services, especially in remote rural areas and also in disadvantaged urban areas, and that general practice is sustainable in all areas into the future. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly-qualified GPs.
The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,637 in 2017 and there are now 2,485 GPs contracted to the HSE under the GMS scheme compared to 2,098 in 2008. It should be noted that as of 1 March there were only 23 GMS panels that do not have a permanent GP in place – a vacancy rate of less than 1%.
In addition, the Government has also taken steps to expand GP training. In 2009, there were 120 GP training places and this year there are 194 GP training places available for the 2018 GP training intake. The Government is committed to further increasing this number to 259 places annually in future years.
Further efforts undertaken in recent years to increase the number of practicing GPs include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday, as well as the introduction of an enhanced supports package for rural GP practices.
It is generally accepted that there is a need to modernise the current GMS contract and ensure that general practice benefits patients while providing for a viable and rewarding career for current and future GPs. The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions.
Engagement with GP representatives on contractual issues will commence in the coming weeks. It is important that any new contract will result in service improvements across general practice benefiting both patients and GPs.
